Comparison of Intermittent Bolus vs. Continuous Infusion PENG Block for Postoperative Pain in Hip Surgery

NCT06834243 | Completed

• 1 other identifier: TNKU-PENG-Retro
• Study Type: observational
• Target: 82
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective study evaluates the effects of two different administration methods of the Pericapsular Nerve Group (PENG) Block on postoperative pain control, opioid consumption, and recovery in patients undergoing hip surgery. All patients in the study received:

• PENG block via a catheter
• Patient-Controlled Analgesia (PCA) with tramadol
• Multimodal analgesia, including IV paracetamol and nonsteroidal anti inflammatory drugs (NSAIDs) as rescue analgesia The study compares two groups:
• Intermittent Bolus Group: A researcher administered 20 mL of 0.25% bupivacaine every 4 hours.
• Continuous Infusion Group: A pump delivered 5 mL/hour of 0.25% bupivacaine continuously.

Conditions

Hip Surgery; Postoperative Pain Management; Pericapsular Nerve Group Block (PENG Block); Regional Anesthesia

Keywords

Hip surgery; postoperative pain; pericapsular nerve group block; analgesia

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Scores (VAS)

  Postoperative pain levels will be assessed using the Visual Analog Scale (VAS, 0-10) where: * 0 = No pain * 10 = Worst possible pain * Higher scores indicate worse pain levels.

  From 0 hours (postoperatively) to 24 hours postoperatively, assessed at 0, 2, 6, 12, and 24 hours.

Secondary Outcomes (5)

• Total Postoperative Opioid Consumption

  From 0 hours (postoperatively) to 24 hours postoperatively, assessed at 0, 2, 6, 12, and 24 hours.

• Quality of Recovery (QoR-15 Score)

  Assessed at 24 hours postoperatively.

• Postoperative Nausea and Vomiting (PONV) Incidence

  From 0 hours (postoperatively) to 24 hours postoperatively.

• Time to First Rescue Analgesia

  From the end of surgery until the first administration of rescue analgesia, assessed up to 24 hours postoperatively.

• Incidence of Complications

  From 0 hours (postoperatively) to 24 hours postoperatively.

Study Arms (2)

Intermittent Bolus Group

Patients in this group received intermittent bolus administration of the Pericapsular Nerve Group (PENG) Block via a catheter placed under ultrasound guidance at the end of surgery. A researcher manually administered 20 mL of 0.25% bupivacaine every 4 hours over a 24-hour period. * Total bupivacaine volume: 120 mL of 0.25% bupivacaine over 24 hours * Additional analgesia: All patients received PCA with tramadol, IV paracetamol, and rescue NSAIDs as per protocol.

Procedure: Intermittent Bolus PENG Block

Continuous Infusion Group

Patients in this group received continuous infusion of the Pericapsular Nerve Group (PENG) Block via a catheter placed under ultrasound guidance at the end of surgery. A pump delivered 5 mL/hour of 0.25% bupivacaine continuously over a 24-hour period. * Total bupivacaine volume: 120 mL of 0.25% bupivacaine over 24 hours * Additional analgesia: All patients received PCA with tramadol, IV paracetamol, and rescue NSAIDs as per protocol.

Procedure: Continuous Infusion PENG Block

Interventions

Intermittent Bolus PENG Block PROCEDURE

Patients received intermittent bolus administration of the Pericapsular Nerve Group (PENG) Block via a catheter. A researcher manually administered 20 mL of 0.25% bupivacaine every 4 hours over a 24-hour period.

Intermittent Bolus Group

Continuous Infusion PENG Block PROCEDURE

Patients received continuous infusion of the Pericapsular Nerve Group (PENG) Block via a catheter. A pump delivered 5 mL/hour of 0.25% bupivacaine continuously over a 24-hour period.

Continuous Infusion Group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study includes adult patients (ages 18-65) who underwent hip surgery at Tekirdağ Namık Kemal University Hospital between November 15, 2023, and November 15, 2024. All patients received Pericapsular Nerve Group (PENG) Block via a catheter for postoperative pain management, along with multimodal analgesia including tramadol PCA, IV paracetamol, and rescue NSAIDs. The study compares two PENG block administration techniques: intermittent bolus versus continuous infusion.

You may qualify if:

• Participants must meet all of the following criteria to be included in the study:
• Patients who underwent hip surgery between November 15, 2023 - November 15, 2024.
• Patients who received Pericapsular Nerve Group (PENG) Block via a catheter for postoperative analgesia.
• Patients who received Patient-Controlled Analgesia (PCA) with tramadol.
• Patients aged 18 to 65 years.
• ASA I - III classification.

You may not qualify if:

• Participants who meet any of the following criteria will be excluded from the study:
• Patients who received analgesia with techniques other than PENG block.
• Patients with incomplete or missing medical records.
• Patients with a psychiatric illness diagnosis that may interfere with pain perception or reporting.
• Patients with coagulation disorders (e.g., INR \>1.5, thrombocytopenia).
• Patients with hepatic or renal failure (Creatinine clearance \<30 mL/min or AST/ALT \>3x normal).
• Patients with chronic opioid use before surgery.

Sponsors & Collaborators

• Onur Baran: lead
• Namik Kemal University School of Medicine, Tekirdag: collaborator

Study Sites (1)

Tekirdağ Namık Kemal University Research Hospital

Tekirdağ, 59000, Turkey (Türkiye)

Location

Related Publications (2)

• Huda AU, Ghafoor H. The Use of Pericapsular Nerve Group (PENG) Block in Hip Surgeries Is Associated With a Reduction in Opioid Consumption, Less Motor Block, and Better Patient Satisfaction: A Meta-Analysis. Cureus. 2022 Sep 6;14(9):e28872. doi: 10.7759/cureus.28872. eCollection 2022 Sep.

  PMID: 36105907 BACKGROUND

• Kukreja P, Uppal V, Kofskey AM, Feinstein J, Northern T, Davis C, Morgan CJ, Kalagara H. Quality of recovery after pericapsular nerve group (PENG) block for primary total hip arthroplasty under spinal anaesthesia: a randomised controlled observer-blinded trial. Br J Anaesth. 2023 Jun;130(6):773-779. doi: 10.1016/j.bja.2023.02.017. Epub 2023 Mar 22.

  PMID: 36964012 BACKGROUND

MeSH Terms

Conditions

Pain, Postoperative; Agnosia

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Study Officials

• Cavidan Arar, Prof. Dr.

  Medical Faculty of Tekirdağ Namık Kemal University

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Asst. Prof.

Study Record Dates

• First Submitted: February 12, 2025
• First Posted: February 19, 2025
• Study Start: November 15, 2023
• Primary Completion: November 15, 2024
• Study Completion: November 15, 2024
• Last Updated: May 14, 2026

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)